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ORIGINAL ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 3  |  Page : 255-259

Programmatic challenges in managing multidrug-resistant tuberculosis in Malawi


1 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University; KNCV TB Foundation, Challenge TB Project, Blantyre, Malawi
2 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Blantyre, Malawi; Kibong'oto National Tuberculosis Hospital, Kilimanjaro, Tanzania
3 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Blantyre, Malawi; Department of Public Health, College of Health Science, Arsi University, Asella, Ethiopia
4 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Blantyre, Malawi
5 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Blantyre, Malawi; Department of Nursing, Saint Peter Tuberculosis Specialized Hospital, Addis Ababa, Ethiopia
6 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Blantyre, Malawi; Hager Biomedical Research Institute, Asmara, Eritrea
7 Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Blantyre, Malawi; Department of Clinical Pharmacy, Soroti Regional Referral Hospital, Soroti, Uganda
8 Department of Professional Practice and Conduct, Nurses and Midwives Council of Malawi, Lilongwe, Malawi

Correspondence Address:
Loveness Charlie
Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, P.O. Box. 9086, Addis Ababa; KNCV TB Foundation, Lilongwe
Malawi
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmy.ijmy_47_21

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Background: Multidrug-resistant tuberculosis (MDR-TB) is one of the most urgent challenges that Malawi tends to take a firm public health action. A recent increase in multidrug MDR-TB cases, a decrease in treatment success rate, and a double increase of lost-to-follow-up call into question the country's programmatic management of MDR-TB (PMDT). As such, the study aimed at exploring programmatic challenges in managing MDR-TB in Malawi. Methods: A comprehensive and nonsystematic search was made in PubMed and Google Scholar using mainly the keywords “MDR-TB” “extensively drug-resistant TB,” Malawi. The study reviewed existing guidelines and gray literature and reviewed data obtained from the national TB program (NTP) as well. Results: The study found the following challenges affecting PMDT: decrease in funding, partial access to GeneXpert, delay in diagnosis, long treatment duration, lack of adequate personal protective equipment, the long turnaround time of culture results, failure to initiate all diagnosed patients on treatment, absence of alternative second-line medicines, and lack of transport from health facilities to patient homes. Conclusion: If the Malawi NTP is to achieve a vision of a “TB-free Malawi,” rigorous efforts at all levels must be made, including mobilizing domestic resources for improved MDR-TB program performance. Developing partners should continue providing the much-needed funding to the Malawi government to stand in the wake of the MDR-TB crisis.


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